Individual provider Active NPI

Prishila Misimi, APRN

  • Nurse Practitioner
  • Maywood, NJ
National Provider Identifier
1609618560
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11033339 Issued in FL
Practice address
114 Grove Ave FL 1
Maywood, NJ 07607-2012
Phone
(904) 881-2062
NPI assigned
Jun 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 26NJ15469200 NJ
Nurse Practitioner 363L00000X APRN11033339 FL Primary

Addresses

Primary practice location

114 Grove Ave FL 1
Maywood, NJ 07607-2012

Mailing address

114 Grove Ave FL 1
Maywood, NJ 07607-2012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250217001755 FL Practitioner - Nurse Practitioner 0446780738 Reassigns benefits to 1 organization
I20251213000021 NJ Practitioner - Nurse Practitioner 0446780738 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

831 Bedford Ave
Suite 530
Brooklyn, NY 11205-2801

915 N Monroe St
Suite 200
Jacksonville, FL 32204

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ15469200NJMDHospice and Palliative Medicine (Family Medicine) Physician
APRN11033339FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Florida Endocrine and Diabetes Associates PA CurrentSince Apr 1, 2025 Accepting new patients
North East Florida Endocrine and Diabetes Assoc PA CurrentSince Apr 1, 2025 Accepting new patients
Patient Care Medical Group PC CurrentSince Nov 19, 2025 Accepting new patients
VK Medical Group LLC PastSince Jun 1, 2024 Accepting new patients

Locations

915 W Monroe St
Ste 200
Jacksonville, FL 32204

1375 Roberts Dr
Ste 206
Jax Bch, FL 32250
Phone (904) 247-1456

26 Main St
Edison, NJ 08837
Phone (609) 385-2622

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1609618560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 GROVE AVE FL 1",
            "city": "MAYWOOD",
            "state": "NJ",
            "postal_code": "076072012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 GROVE AVE FL 1",
            "city": "MAYWOOD",
            "state": "NJ",
            "postal_code": "076072012",
            "telephone_number": "904-881-2062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISIMI",
        "first_name": "PRISHILA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-11",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "NJ",
            "license": "26NJ15469200",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11033339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, NJ

Sources for this page

Verify at the official NPI Registry.